| U.m.o.m.s.a. | |
|
650 W. Baltimore St, Suite 1401 Baltimore MD 21201-1501 | |
| (410) 706-6195 | |
| (410) 706-4199 |
| Full Name | U.m.o.m.s.a. |
|---|---|
| Speciality | Oral & Maxillofacial Surgery |
| Location | 650 W. Baltimore St,, Baltimore, Maryland |
| Authorized Official Name and Position | Stewart A Bergman (PROFESSOR) |
| Authorized Official Contact | 4107066195 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| U.m.o.m.s.a. Po Box 23531 Baltimore MD 21203-5531 Ph: (410) 706-6195 | U.m.o.m.s.a. 650 W. Baltimore St, Suite 1401 Baltimore MD 21201-1501 Ph: (410) 706-6195 |
| NPI Number | 1538221825 |
|---|---|
| Provider Enumeration Date | 12/14/2006 |
| Last Update Date | 10/01/2007 |
| Medicare PECOS PAC ID | 1153392162 |
|---|---|
| Medicare Enrollment ID | O20040803001689 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1538221825 | NPI | - | NPPES |
| Provider Name | John F Caccamese |
|---|---|
| Provider Type | Practitioner - Maxillofacial Surgery |
| Provider Identifiers | NPI Number: 1467446344 PECOS PAC ID: 6002882321 Enrollment ID: I20040908001081 |
| Provider Name | Gary Warburton |
|---|---|
| Provider Type | Practitioner - Maxillofacial Surgery |
| Provider Identifiers | NPI Number: 1962545947 PECOS PAC ID: 2961589098 Enrollment ID: I20080522000275 |
| Provider Name | Robert Andrew Ord |
|---|---|
| Provider Type | Practitioner - Maxillofacial Surgery |
| Provider Identifiers | NPI Number: 1730180043 PECOS PAC ID: 5294877270 Enrollment ID: I20101022000819 |
| Provider Name | Joshua E Lubek |
|---|---|
| Provider Type | Practitioner - Maxillofacial Surgery |
| Provider Identifiers | NPI Number: 1134258817 PECOS PAC ID: 0446306781 Enrollment ID: I20101214000927 |
| Provider Name | Donita Dyalram |
|---|---|
| Provider Type | Practitioner - Maxillofacial Surgery |
| Provider Identifiers | NPI Number: 1013107572 PECOS PAC ID: 6204089634 Enrollment ID: I20130114000354 |
| Provider Name | Nicholas R Wilken |
|---|---|
| Provider Type | Practitioner - Maxillofacial Surgery |
| Provider Identifiers | NPI Number: 1467845214 PECOS PAC ID: 4789981523 Enrollment ID: I20211005000090 |
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